Chapter 3 Current Issues in Clinical Psychology

I. Prescription Privileges
A. Reasons for Prescribing
1. Shortage of Psychiatrists
2. Clinical Psychologists are more expert than Primary Care Physicians
3. Others do (Dentists, Podiatists, Optometrists, Nurse-Practitioners) have privileges
4. Convenience for clients
5. Professional autonomy
6. Professional identification
7. Evolution of the profession
8. Revenue for the profession
B. Reasons Against Prescribing
1. Training Issues (length and quality)
2. Threats to psychotherapy
3. Identity confusion
4. Negative influence of pharmaceutical industry
C. Prescription Privileges available in New Mexico, Louisiana, Illinois, Iowa, and Idaho

II. Manualized Therapy
A. Advantages
1. Scientific legitimacy
2. Establishing minimal competence
3. Training improvements
4. Decreased reliance on clinical judgment
B. Disadvantages
1. Threats to the psychotherapy relationship
2. Diagnostic complications
3. Restrictions on practice
4. Debatable criteria for empirical evidence

III. Overexpansion of Mental Disorders
A. Diagnoses are profitable to those who assess and treat people
B. Approximately twice as many people take psychiatric medications now compared to 15 years ago
C. New diagnoses are added with some disagreement such as binge eating disorder and premenstrual dysphoric disorder
D. Some diagnoses have less stringent criteria such as ADHD onset by age 12 instead of age 7, binges in bulimia nervosa once per week instead of twice

IV. Influence of Technology
A. Cybertherapy that includes videoconferencing, email, texts, websites, virtual reality, and handheld devices to collect data
B. Importance of electronic informed consent, confidential encrypted records, and clear information about therapist availability